C H Flores-Balcázar1, D M Urías-Arce1, M T Bourlon2, F Gabilondo-Navarro3, S I Pérez-Álvarez1, R Ramos-Prudencio1, F Rodríguez-Covarrubias3. 1. Radiotherapy and Medical Physics Service, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México City, Mexico. 2. Clinic of Genitourinary Tumors, Medical Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México City, Mexico. 3. Urology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México City, Mexico.
Abstract
AIM: The purpose of this study was to review genitourinary (GU) and gastrointestinal (GI) toxicity associated with high-dose radiotherapy (RT) delivered with 3-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT) or volumetric arc therapy (VMAT) following radical prostatectomy (RP). BACKGROUND: RP is a therapeutic option for the management of prostate cancer (PrCa). When assessing postoperative RT techniques for PrCa, the published literature focuses on patients treated with 2-dimensional conventional methods without reflecting the implementation of 3D-CRT, IMRT, or VMAT. MATERIALS AND METHODS: A total of 83 patients were included in this analysis; 30 patients received 3D-CRT, and 53 patients received IMRT/VMAT. Acute and late symptoms of the GU and lower GI tract were retrospectively graded according to the Radiation Therapy Oncology Group and the European Organization for Research and Treatment of Cancer radiation toxicity grading systems. The relapse failure-free rate and overall survival were also evaluated. RESULTS: The rate of acute GU toxicity was 9.4% vs. 13.3% for the IMRT/VMAT and 3D-CRT groups (p = 0.583). The 5-year actuarial rates of late GI toxicity for IMRT/VMAT and 3D-CRT treatments were 1.9% and 6.7%, respectively. The rate of late GU toxicity for the IMRT/VMAT and 3D-CRT treatment groups was 7.5% and 16.6%, respectively (p = 0.199). We found no association between acute or late toxicity and the RT technique in univariate and multivariate analyses. CONCLUSION: Postprostatectomy IMRT/VMAT and 3D-CRT achieved similar morbidity and cancer control outcomes. The clinical benefit of highly conformal techniques in this setting is unclear although formal analysis is needed.
AIM: The purpose of this study was to review genitourinary (GU) and gastrointestinal (GI) toxicity associated with high-dose radiotherapy (RT) delivered with 3-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT) or volumetric arc therapy (VMAT) following radical prostatectomy (RP). BACKGROUND: RP is a therapeutic option for the management of prostate cancer (PrCa). When assessing postoperative RT techniques for PrCa, the published literature focuses on patients treated with 2-dimensional conventional methods without reflecting the implementation of 3D-CRT, IMRT, or VMAT. MATERIALS AND METHODS: A total of 83 patients were included in this analysis; 30 patients received 3D-CRT, and 53 patients received IMRT/VMAT. Acute and late symptoms of the GU and lower GI tract were retrospectively graded according to the Radiation Therapy Oncology Group and the European Organization for Research and Treatment of Cancer radiation toxicity grading systems. The relapse failure-free rate and overall survival were also evaluated. RESULTS: The rate of acute GU toxicity was 9.4% vs. 13.3% for the IMRT/VMAT and 3D-CRT groups (p = 0.583). The 5-year actuarial rates of late GI toxicity for IMRT/VMAT and 3D-CRT treatments were 1.9% and 6.7%, respectively. The rate of late GU toxicity for the IMRT/VMAT and 3D-CRT treatment groups was 7.5% and 16.6%, respectively (p = 0.199). We found no association between acute or late toxicity and the RT technique in univariate and multivariate analyses. CONCLUSION: Postprostatectomy IMRT/VMAT and 3D-CRT achieved similar morbidity and cancer control outcomes. The clinical benefit of highly conformal techniques in this setting is unclear although formal analysis is needed.
Authors: Frank Friedersdorff; Laura Buckendahl; Leonie Alt; Andreas Maxeiner; Stefan Hinz; Anna Bichmann; Kurt Miller; Ahmed Magheli; Jonas Busch Journal: World J Urol Date: 2019-08-28 Impact factor: 4.226
Authors: Andrew J Stephenson; Peter T Scardino; James A Eastham; Fernando J Bianco; Zohar A Dotan; Paul A Fearn; Michael W Kattan Journal: J Natl Cancer Inst Date: 2006-05-17 Impact factor: 13.506
Authors: Ian M Thompson; Catherine M Tangen; Jorge Paradelo; M Scott Lucia; Gary Miller; Dean Troyer; Edward Messing; Jeffrey Forman; Joseph Chin; Gregory Swanson; Edith Canby-Hagino; E David Crawford Journal: JAMA Date: 2006-11-15 Impact factor: 56.272
Authors: Gregg H Goldin; Nathan C Sheets; Anne-Marie Meyer; Tzy-Mey Kuo; Yang Wu; Til Stürmer; Paul A Godley; William R Carpenter; Ronald C Chen Journal: JAMA Intern Med Date: 2013-06-24 Impact factor: 21.873